Dr. WANG Yu graduated from Beijing Medical University in 1982. He continued onto his graduate study at the Institute of Hepatology, Beijing Medical University from 1983 to 1989 and received his Master’s and Doctorate of Medicine during this period. From 1991 to 1993, he studied at the Jichi Medical School in Japan and received a Ph.D. degree in Preventive Medicine. In 1999, He completed Master of Business Economics program from the Chinese Academy of Social Sciences. Starting in 1985, he had been an assistant professor, associate professor, professor, deputy director and director of the Institute of Hepatology in Beijing Medical University, specializing on hepatology and viral molecular biology. Dr. Wang had participated in and chaired a number of national scientific and technological projects and programs, such as the Natural Science Foundation of China. He served as a committee member of the Chinese Medical Association and vice chairman of the Medical Virology Branch of the Chinese Medical Association. Since 1996, he had served as the Executive Vice-Director and Director of the Office of Scientific Research in Beijing Medical University, and Deputy Dean, School of Medicine, Peking University. From 2000 to 2003, he was appointed Deputy Director of the Center for Biological Engineering and Development, China Ministry of Science and Technology. From 2003 to 2004, he was Deputy Director of the Office of Rural and Social Development at the Ministry of Science and Technology. In June 2004, he was appointed as the Director of Chinese Center for Disease Control and Prevention under the Ministry of Health, China.

Dr. Wang was invited to have a phone interview with the China Health Policy and Management Society in August. The interview was conducted by Dr. Chiu-fang Chou on September 8, 2012. Drs. Zhuo (Adam) Chen and Zheng Li from CHPAMS also participated in the interview. CHPAMS acknowledges help from Ms. Doris Wang, Mr. Lin Wang, and Ms. Xuhong Ding in facilitating the interview.

1. Education and Work Experience教育和工作经历

Chiu-fang: What made you choose medicine as your career, and why did you select hepatology as your specialty?

周秋芳博士：您在1989年取得北京医科大学的博士学位，是什么原因促使您选择医学作为自己的职业?另外在各学科中您为什么选取肝病做为研究方向?

Dr. Wang: After graduated from high school, I worked for three years at a printing factory, because of the social structure at the time. In the first year when China resumed the College Entrance Examination, I took the exam and was accepted into the Beijing Medical University (now Peking University Health Science Center), thanks to my high school teachers for my solid academic foundation. I chose medicine as my career because of the influence from the society and idealism, and also because I had always been interested in health, health care, medicine and traditional Chinese medicine. Therefore, stepping out of a printing factory, I became a college student in a medical school.

After a few years in the medical school, I chose hepatology as my specialty again because of needs of the society and the profession. Hepatitis was a big problem in China at that time. In addition, I was very interested in immunology when I was in Beijing Medical University, and I recognized the importance of immunity in regulating human body’s functioning, so I decided to focus my research on hepatitis virus.

Chiu-fang: After graduation, how did you find the opportunity to study abroad in Japan? While studying in the Jichi Medical School from 1991 to 1993, how did you adapt to the life as an overseas student? How did the several years of overseas study in Japan influence your career and life?

Dr. Wang: China and Japan have a long and active history of medical exchange. My professor specializing in liver disease prevention was in close contact with his Japanese academic peers at the time, so I had many communications with Japanese experts when I was in graduate school. Plus China provided scholarship for studying abroad in many different countries, such as Japan, the United States, Australia and others, so I went to study in Japan with the support from the Chinese government.

Three years of study in Japan had a profound influence on me. At that time, there were few students from China and other Asian countries in the school, and professors had very good relationship with students. I got to know Japanese people, culture and society, in addition to Japanese language, which I think is better than my English. I also learned Japanese’s attitudes towards study and research, witnessed their rigorous and serious demeanor, and recognized their hardworking and spirit of self-reliance. I worked in the lab for 365 days a year without a break, and only one or two days of rest in the New Year holiday break. Everyone was working around the clock in the lab, and our self-study and rigorous attitudes manifested in my academic research and in my life. I also completed a doctorate within a short period of time, and this experience led to my rigorous attitude towards work and scientific research.

Chiu-fang: Can you talk about how you felt when you took over as the director of the China CDC in 2004?

周秋芳博士：可不可以谈谈您在2004当时接任中国CDC主任的心情?

Dr. Wang: At that time, I did not have any preparation in my mind at all because I was appointed to that position. After taking on the duty, I realized that it was a huge challenge as I could not expect what would be happening later on. Prior to this, I had been working on biochemical research development, and I had not managed on a macro scale, so it was a challenge. However, it was very helpful with the trust from the leadership and support from colleagues at the China CDC and those from the provincial, city and county CDCs. We often say that "the CDCs in the whole world are a family", because our work needs everyone's cooperation, which is different from the work in the hospital. Eight to ten years of work experiences at the China CDC, for me, are very meaningful, because I followed the development of the country and contributed to China’s public health.

2. The decade at China CDC疾控十年

Chiu-fang: 2012 is the tenth anniversary since China Center for Disease Control and Prevention was officially established. The accomplishments of China CDC are widely recognized. What do you think are the most outstanding achievements in the past decade and what should be the focus of future development?

Dr. Wang: This is an important question. The basic characteristic of the China CDC is the renewed focus of “Prevention First”, which is what the Chinese government has been advocating. During the emergency of the SARS epidemic, the importance of China CDC was abruptly raised to a new level. During the past decade, disease prevention and public health have received significant support from the Chinese government and especially, have been recognized by the society and the public.

After the establishment of the People’s Republic of China, we used to have a good prevention framework. Unfortunately, it was weakened and ignored during the rapid development of the economic and social system. During the SARS epidemic, disease prevention demonstrated its importance. Chinese people realized that public health is closely related to the basic social structure and function, and that the defense of public health is one of the most basic conditions for the protection of the people. With such understanding, we received consensus and attention from the nation, provinces, cities and counties, so our prevention efforts can be successfully implemented.

Chiu-fang: What are the mid-term and long-term goals of the China CDC? How to achieve these goals?

周秋芳博士：未来中国疾病预防控制中心正的中期和长期目标是什么？将如何实现这些目标呢？

Dr. Wang: Ten-year is a long time for most people; however, from the perspective of social development, it is a very short period of time. During the past decade, in my opinion, we have built a basic public health framework, and we have only positioned disease control and prevention and public health in the government's public service system. The public have had a preliminary understanding towards our disease prevention and control institutions, for example, people recognize that specific infectious diseases, emergencies and chronic disease prevention and control should be handled by the CDC.

Next, we will need to focus on standardizing and continuously improving the public health system. Despite of the platform developed in the last decade, the disease prevention and control system in China still lacks standardization and systematization, compared with that of clinical medicine, which has hundreds of years of history and has developed into a standardized systematic discipline. In contrast, our disease prevention and control system has a long way to go on aspects like framework, infrastructure, mechanism, implementation, as well as the human resource development and distribution. Now that we have already known public health’s social function and social positioning, how to make it a more perfect system is what China CDC will focus on in the next period.

Chiu-fang: What are the major international collaborative projects of Chinese CDC? Are there any collaborative or exchange projects with disease control agencies in other countries (such as the U.S. CDC)?

周秋芳博士：中国的CDC与国际合作的重大合作项目有那些? 中国CDC 和其他国家疾病控制部门（如美国CDC）未来有什么合作交流项目?

Dr. Wang: Global health is the health issues and challenges need to be addressed by the entire world, which requires global cooperation. Infectious disease has no borders. Chronic disease prevention also requires global collaboration. On the other hand, in recent decades, China has had many great public health accomplishments with a modest investment, a huge population and an under-developed economy. China’s experience could be adapted by other developing countries for their use. Globalized and undergoing reform, China should actively consider, explore and implement the appropriate means to introduce our experience to other developing countries, such as on vaccination and cholera prevention. Many diseases are under well control in China, but outbreaks still occur in other development countries, so we can provide our success stories for them.

In addition, the Chinese experts of disease prevention should also gain more global experience. We must step outside to understand the international public health, and get a better knowledge of the current development of public health and prevention in other countries. Only participating in international conferences and regular research is not enough to understand the social system and disease prevention in other countries, and the common international practices. If we don’t understand the practices, it’s impossible for us to communicate and discuss with experts from other countries. The US CDC has 9,000 to 10,000 employees and contractors, many of them have working experience in developing countries, ranging from one year to as many as eight years. And many experts stationed in China CDC from U.S. CDC have the same qualification.

In contrast, many of our experts had no experience working in the developing world until last year. Hence we should be more active in addressing globalization. Since last year (2011), we have collaborated with the World Health Organization, the U.S. CDC to send disease prevention experts to help Ethiopia and Namibia with planned immunization. Since the second half of last year (2011) until this year (2012), we have two groups of experts in Pakistan developing a program of immunization, with 10 experts from the China CDC and provincial CDCs implementing projects with the WHO team across Pakistan. In addition, we have a group in Cambodia to help eradicate the enterovirus-71 infection, provide reagents for children Hand Foot Mouth Disease and teach local staff members to screen for the virus.

We are very actively participating in global health efforts; with frequent international exchanges. Our experts go abroad to attend international conferences, and foreign experts visit to China CDC on every basis. Each year, we have more than 300 groups leaving abroad for exchange and study, and more than two hundred groups of visiting foreign experts.

3. China's Health Care Reform and Public Health中国医疗改革与公共卫生

Chiu-fang: What impacts do you think that China’s healthcare reform as well as the development of the healthcare sector during 12th Five-Year planning will have on China’s public health?

周秋芳博士：您觉得中国已推出的医疗保健制度改革及中国“十二五”时期医疗卫生事业的改革发展对公共卫生有何影响?

Dr. Wang: There will be long-term impacts. Treatment and disease prevention are like two legs, which are equally important. After the SARS event, China paid great attention to public health and disease prevention, and the government had invested tens of billions to develop the infrastructure of prevention. To advance the health care reform, the primary issue is to solve people’s problem in accessing a doctor, so our current focus should be placed here. At the same time, we should not ignore the development of disease prevention and control system. We must understand that solving people’s health issues doesn’t rely on treatment, and medical resources should not be completely focused on a specific disease or terminal illness; part of health resources should be placed on the prevention and disease control, and health promotion.

Chiu-fang: China is experiencing a rapid economic growth, and people’s diet has changed a lot. China's dramatic increase in the number of people with chronic diseases has become a major threat to public health. Are there any prevention efforts by the Chinese CDC for this?

Dr. Wang: This is a global problem. Although it appears to be simple, this question is brought up within the last 10 or 20 years and no solution is available yet. Most people believe that unhealthy habits or behaviors could be changed through health education or improvement of health knowledge. However, some case studies are disturbing. For example, the tobacco-controls issue. Tobacco control is not an issue concerning just knowledge, as 60% of Chinese male doctors smoke; they do not lack health knowledge. Another example is obesity in the United States. We all know that obesity is not good and leads to many chronic conditions, but still we can’t solve this problem. Therefore, health education alone isn’t enough to identify a good solution, and we should continue to explore the effective methods of chronic disease control.

Chiu-fang: What do you think is the most significant achievement of China's public health surveillance system? Which aspects need improvement?

周秋芳博士：目前中国公共卫生监测系统您认为做得最好的是什么，需要继续努力的是哪方面？

Dr. Wang: After the SARS event, we found out that we had a problem with the ability of real time reporting of outbreak information. Over the past decade, we have established the Internet-based epidemic detection and reporting network covering the whole country. The network plays a great role in epidemics such as Avian flu and H1N1 outbreaks and sporadic breaks of other infectious diseases. As for AIDS, tuberculosis and cholera, the network is able to show the movement of infected population.

However, this system is based on an electronic spreadsheet rather than a true Internet technology. Our next step is to combine with the development health information system under the aegis of the healthcare reform; through linking hospitals' electronic medical records system, community health records and the public health infectious disease information with modern IT technology, the important health-related information can always be presented anywhere in the country in real time, so as to establish a real health information network.

Chiu-fang: Is it possible that China CDC share its data with academic institutions or other organizations?

周秋芳博士：有没有可能中国CDC与学术界或其它单位共享中国CDC的数据?

Dr. Wang: In China CDC, there are two kinds of data. One is the work-related data, which is confidential, and only for CDC internal use; the other is the epidemiologic data, which is publicized monthly by the Ministry of Health, and the specific data can be accessed. At present, domestic universities and academics have published many top-notch articles using these data.

Chiu-fang: In your opinion, what are the challenges that China’s public health is facing?

周秋芳博士：您认为中国公共卫生目前面临的挑战是什么?

Dr. Wang: The biggest challenge is how to properly disseminate the evidence-based disease prevention and control to the public, because health is the prerequisite for the development of the society. We must combine the evidence-based medicine with the needs of the public.

4. Words to the China Health Policy and Management Society寄语中国卫生政策和管理学会

Chiu-fang: the China Health Policy and Management Society is a rapidly growing professional organization. Do you have any advices or suggestions for us?

周秋芳博士：中国卫生政策和管理学会是一个迅速发展的专业社团。您对我们有任何期望与建议吗？

Dr. Wang: Health policy and management is a very promising field in China. The health problems of over 1.3 billion Chinese people represent the health needs of billions of people in the world's developing countries. We are exploring on how to promote the health of the public -- a process requires a large number of talents to provide support concerning health policy and management. With lots of questions but few answers, we especially need people to actively participate to meet the demand accompanying the development of the society. Especially with rapid economic growth and social development, there will be a lot of profound social transformations, which will bring a series of changes. This process requires extensive research, demands us to recognize these changes. Hence, the work of CHPAMS is very meaningful, and I hope we can continue to collaborate at different levels and aspects in the future, and together we contribute to China's public health.